E86 Kwadwo Kyeremanteng on Solving Healthcare podcast, Solving Wellness, and Health Communication

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Kwadwo Kyeremanteng  00:00

Rightfully or wrongfully, I like to behave as if my kids were watching. They can see what was happening. For me to, with the platform, not to stick up and do the right thing, it never sat well with me.

Chad Ball  00:24

Welcome to the Cold Steel surgical podcast, with your hosts Ameer Farooq and Chad Ball. We’ve had the absolute privilege of chatting with some amazing Canadian, as well as international, guests over the past year. While the topics have been broad in range, whether clinical, social or political. Our aims for the podcast continue to remain the same. We hope to inspire discussion, creativity, scholarly research, and career development in all Canadian surgeons. We hope you enjoy our second season as we continue to highlight some incredible guests, deliver detailed masterclass sessions on a myriad of clinical topics and introduce some fresh new features such as debate and companion formats. We hope you relish the podcast as much as we do.

Ameer Farooq  01:07

To paraphrase Shakespeare, some podcasts are born great, some achieve greatness, and some have greatness thrust up them. The Solving Healthcare podcast hosted by Dr. Kwadwo Kyeremanteng falls into all 3 categories. Dr. K, as he is fondly known, is an intensivist based out of Ottawa and his podcast, Solving Healthcare, has been a tremendous source of amazing and excellent information on COVID-19, medicine, exercise, nutrition, and so much more. As if he wasn’t busy enough, Dr. K has now also created the Solving Wellness platform, an online website and community that is targeted at wellness for healthcare workers. It was an absolute pleasure on this episode to throw down with Dr. K. We talked about our shared Edmontonian heritage, his work with the Solving Healthcare podcast and the Solving Wellness platform. We are super excited to announce that Cold Steel listeners can receive a free membership on the Solving Wellness platform. If you go to the Solving Wellness website: www.drkwadwo.ca/solvingwellness and enter promo code ColdSteel, you can get a free membership with the Solving Wellness platform. There are only 10 free memberships, so hurry and join as soon as you can. Remaining listeners can still get a 15% discount on their membership fees at Solving Wellness if you use promo code, ColdSteel15. Enjoy our conversation with Dr. Kwadwo Kyeremanteng from the Solving Healthcare podcast. Dr. Kyeremanteng, thank you so much for joining us today on Cold Steel. It’s a pleasure to have a true bonafide Canadian podcasting icon on with us on the show today. So thank you so much for joining us.

Kwadwo Kyeremanteng  03:12

Ameer, I’m jazzed up for this, buddy. I’m really excited, thanks for having me. This is big.

Ameer Farooq  03:18

So listen, we’re 3 Edmontonians boys on the call today.

Kwadwo Kyeremanteng  03:23

What? I didn’t realize we were representing E-town, all of us!

Ameer Farooq  03:26

That’s right!

Kwadwo Kyeremanteng  03:27

All stand up, all stand up!

Ameer Farooq  03:29

I know, it’s shocking! There are things that happen in E-town, besides West Edmonton Mall. So, I want to talk about that. Tell us about growing up on the on the mean streets of Edmonton, where in the city did you grow up? And how did that shape you?

Kwadwo Kyeremanteng  03:49

It’s kind of funny when you mention it Ameer, it is kind of mean street. I grew up in the west end, about 10 blocks from the mall in a community called Aldergrove. Now I look back… #1, I’ll say my youth, the crew that I grew up with, it was an unbelievable childhood. You could go outside and you had about 2, 3 kids your age that you were ready to play with, So I was always outside playing hockey, basketball, soccer, football. Anything you can think of, we were in the mix. But it was a good mix of kids that, you know, some didn’t make it out of the hood. Most of them didn’t make it out of the hood, and got into some, not the ideal lifestyle. But some of us ended up making the most out of our education and ended up getting some pretty established careers. But I loved my childhood, honestly. Growing up an Oilers fan. I’m old enough to remember all 5 cups. Well, maybe not the first couple but especially growing up playing hockey, it was pretty special. But Aldergrove, I would walk to the mall. I’d spend my summers with those mall passes. I don’t know if you remember that Ameer, you get one of those passes and you could go to the waterpark, the mini golf and the fantasy land. So I’d spend my summers there. I loved my childhood, though. I loved it.

Ameer Farooq  05:24

Yeah, it’s awesome to listen to you talk about E-town so fondly because I think E-town, unrightfully, gets a bad rap. But I do want to ask you one part of growing up in Edmonton that, I don’t know, I wonder what your thoughts are about this. I grew up in Sherwood Park, which, to those people who are not in Edmonton or from that region, you kind of know that Sherwood Park is a little bit one of the suburbs, essentially of Edmonton. Although I’m going to get flack from Sherwood Parkians for saying that. But essentially, it’s like a big suburb of Edmonton. And there were not a lot of nonwhite people when I grew up. What was your experience growing up in Edmonton at the time you did, in terms of being a black child and then, a black man?

Kwadwo Kyeremanteng  06:10

Yeah, I’ll be honest with you. You were aware that you were different at a very early age. Like, growing up in that era, I was called everything you can think of, as of the age of 4, 5, 6. You know, n-word, monkey, having kids tell you to go back to Africa. And adults not saying much when they hear their kids saying these things. So you did feel alienated at a very early age, you were aware that you were different. It was tough. There was this need to always… you always knew that there was eyes on you everywhere you go. It sounds bad to say, but one of my nicknames growing up was “Black people”. Because wherever I’d go, I’d be the only Black person, so I’m representing Black people. So you literally always had to be conscious that there’s eyes on you, always. You never go unnoticed. And that affects the way you act, it affects the way you carry yourself. So those memories growing up, we’re definitely not fond. I remember even being on the ice. Most of my recollections of racist encounters were, for sure, playing hockey. I remember at times just telling yourself, just survive this game. People hacking you, calling you names as they go by. And I wasn’t a big kid. You had to fend for yourself. It was tough. I think it definitely shaped me to who I am now, though. I think, as a result, you end up being a bit more resilient individual. You kind of have that chip on the shoulder saying, I’m not gonna let these guys dictate my future, dictate who I am, just because I look different. I have no doubts that has produced more challenges in terms of career paths, and so on. But once you get through, buddy, you end up being strong, you end up being resilient. And I think if it wasn’t for some of those experiences, I don’t know if I’d be where I am today.

Chad Ball  08:32

Yeah, that’s true. Again, speaking, humbling, as a middle-aged White guy, effectively, I certainly can’t identify with what you guys would have experienced. But that’s been my observation as well. One of my very best friends is a guy named Julius Ebinu, who we’ve had on the podcast. He’s a neurosurgeon now. Him and his family, his 2 brothers, they came from Swaziland when they were in grade 9 and 10. I remember observing a lot of the same behaviors and honestly fighting with, or on his behalf, every single day for a long period of time. And I remember, his dad is a very, very clever guy, and he said, there’s a solution to this, you’re going to educate the shit out of this, and move in some direction that you want to move in. And that’s what he did. He got a PhD at U of A, postdoc at Harvard, becomes a neurosurgeon. Super high-end guy, just like yourself. I’m curious from your point of view. Growing up in the environment you described, what are some of the things that maybe allowed folks like you and Julius to be so successful versus others? Who may be, as you said earlier, are still on the mean streets of where they grew up, or left there.

Kwadwo Kyeremanteng  09:56

That’s a good question, Chad. It’s just to put a finger on, I know my parents were big on education. Like huge on it. Even at the foresight, I went to Holy Cross, a French Catholic school. Like my parents don’t know, they don’t speak French. But they had kind of the insight to say, let’s make this kid, let’s make 3 of the 4 of us multilingual. So it was always a point of emphasis. I don’t know, my parents really modeled that you got to aim high. I got 2 of my sisters are dentists. My dad was a manager of the Farm Safety Program for the provincial government and my mom did clerical work within the provincial government as well. But it was just clear that we got to aim high and my parents were strict. You’d come back home with mediocre marks and they would say, this ain’t good enough. Constantly saying, this ain’t good enough, remember? Look at the color your skin, buddy. You’re up against Jason Smith and you have the same credentials, who the hell do you think they’re going to take? And so that constant message was instilled in you. You need to do more, you need to keep banging at it. And, I don’t know. Part of me wonders too. I was an asthmatic kid and had this amazing pediatrician, actually Conradys, I don’t know if you know them. Yeah, so depending on which camera you’re talking about. The grandpa or the dad was my pediatrician and this man was phenomenal. He walks into the room and all of a sudden, you know you’re okay. And to have that, what’s the word? That kind of impact on a child and their family. That’s forever imposed on you. And I remember thinking I want to be able to do the same thing. All these things, I think, helped in terms of pushing forward. But I mean, once again, it was a uphill battle. Once you get a chance to apply, once you get a chance to get your foot in. I’ve always had to, unfortunately, have those extra layers of steps to get to where I am. But yeah, it’s a good question, Chad.

Ameer Farooq  12:28

Well there’s so much we could talk to you about this topic, and many others, for sure about E-town. But I really do want to talk to you a little bit about all the work that you’ve done with the podcast, which is called Solving Healthcare. But before we get to the podcast, you had actually done some groundwork in building this resource optimization network prior to actually starting with a podcast. Can you tell us a little bit about what the resource optimization network is and was? And how did that lead you to making the podcast?

Kwadwo Kyeremanteng  12:57

Thanks for the question, Ameer. I’ll give the short version. As a trainee, I couldn’t, all of us, you can’t help to not notice the inefficiencies in healthcare and how they were impacting patient care. So I’ll give a quick example. I had a young trauma patient that was a quadriplegic that was heavily reliant on chest physio to be able to get them off the ventilator. And we go into an era of cutbacks, physio is cut, doesn’t get physio on a long weekend. Ends up plugging and coming back to the ICU. And I’m telling myself, how are we so short sighted? How can we not see all these inefficiencies and how it’s impacting patient outcomes. And the same token word, admitting a 92-year-old from an old age home that is demented and doesn’t even want to have aggressive measures, but because of poor documentation, inability to get ahold of family or whatnot, we’ve given them a $15,000 treatment in the ICU. Once again, treatment that they never would have wanted. And so I’m like, we got to do better. So for me, I end up doing a Master’s of Health Admin. A resource optimization network we produced by just gathering a team. It was doctors, nurses, health economists, pharmacists, members from Telfer School of Management. Which, they’ve been amazing for helping out with modeling and so forth. And to me, the reason I’ve been putting so much emphasis on cost is because when it comes to decision makers, they care about that bottom line. If you can show them that an intervention is going to reduce your spending and improve outcomes. How can you say no to that? So then we just hustled, put together a ton of projects. You know, our peak, I’d say we’re doing about 20 publications a year. And then, around 2019, I was looking at our body of work and I was telling myself, we’re doing all this hustling and nothing’s changing. Like, legit, nothing’s changing. And so then we spawned the podcast, Solving Healthcare, just to try and improve that knowledge translation piece. So it kind of stemmed from the clinical side, seeing the inefficiencies, and then really building a team to try and come up with solutions on how we can be more cost effective.

Chad Ball  15:30

You know, I’m glad you just said that, because it reaffirms maybe that this is a problem everywhere, the nothing’s changing comment. Which can be so depressing and demoralizing to a group of people who are passionate and have worked tons of hours to try and make some sort of quality improvement in their work environment. So I’m curious, basically 2 questions based on that. The first is, no matter how altruistic we are, no matter how hard we work at this, no matter the small gains we may make, there’s always the naysayers, the obstacles, the haters. So I am curious, in your experience, with the resource optimization network, what some of those challenges were? Then I’m also curious, in addition, to defining them. Beyond, for example, some of the stuff you talk about in your podcast, what would you recommend in terms of trying to meet those challenges and deal with some of those obstacles in folks who are not all in like a lot of us try to be?

Kwadwo Kyeremanteng  16:28

This is a fantastic question. I don’t know if I’m the best person to answer, but I’ll tell you what my approach has been. So we talked about earlier, you get that body armor or the resilience, I think, by some of the obstacles you go through as a kid or even growing up within medicine. And often when you hear, who cares about this research? Or like, we’re not really interested. Some of us would be like, okay, maybe I should switch gears. But developing that resilience and you having that vision, you realize that not everybody is right, even if they have that title. This was something for me, for example, which was so obvious that this is such an important issue. How can we say no to approaching these problems, because there was tons of naysayers. I funded my own research. I ended up hiring my own research assistant. By the way, which was one of my top moves in terms of in my career, Cynthia Wan, thank you. Paid $20 an hour to try and ramp up my productivity. But there was groups I was part of, no one wanted to fund this. And the vision was screaming to me. I’m like, this is too important. I think this is gonna work. So my answer to you, Chad, was mostly, I just show the product. Instead of trying to maybe get more buy in by the people that are decision makers and so forth, my approach was, I’m just going to show you. I’m going to show you that this is legit. Even though you don’t want to fund it, you’re gonna say it’s not research, looking at cost evaluations, I’m going to show you that it’s going to make a difference. Honestly, I love it when people say, you can’t do this. It’s actually kind of like, it’s almost an addiction. It’s kind of like, I don’t know if you guys watched the the Michael Jordan documentary Last Dance, I think it was called. But along those lines where like, yeah, ou’re washed up MJ, you’re washed up MJ. Be like, okay, all right, I’ll show you, it’s time to dance. Same thing with the research. Okay, we’ll put together a team. We’ll start with some low impact journals, putting some publications in there. And then before you know it, you’re producing papers in BMJ, we got one coming out in New England, should be anytime now, actually. And honestly, it was because we just start to produce. We made that decision to just do it, you know what I mean? And then others will follow and before you know it, when you have that proof of concept by publishing, by doing it, how can they not follow? That’s been my mantra, and it’s served me well.

Chad Ball  19:36

That’s great advice, right? You see that across all fields. I think we all do. You know, people that feel slighted and use that as fuel. A lot of the hyper performers like you that that we’re around day to day, and there’s not that many of them, that is a really common feature and driver in their professional and sometimes their personal lives as well. So, good on you, keep going. And what you’re doing is amazing.

Kwadwo Kyeremanteng  20:04

Thanks very much, Chad.

Ameer Farooq  20:06

You know, I think that’s a good segue to actually talking specifically about the podcast. It’s been fun in preparing to talk to you, to go back and listen to a bunch of the very beginning, in the first couple episodes. And the clarity of vision was there right from the beginning. One of the things that I loved, right from the get go, you’re like, listen, this podcast, it’s not going to be something where… and you do this, great nasal kind of voice like, oh, what was the p-value? Was that significant or not? I was like this, this guy knows exactly what turns people off. Why do you think it has been so hard for health professionals, physicians, scientists, to actually make that transition to being able to talk to the general public and actually make bridge from science to actually talking to the general public?

Kwadwo Kyeremanteng  20:55

Oh, sorry. It just brought me back. I almost forgot about that clip. Yeah, all right, let’s talk about that p-value and the number needed to treat… Yeah, no, honestly, it’s because we don’t have that much diversity in who we bring into medicine. It’s very type A, we’re very sheep, we follow the leader, we don’t divert from the norm. And if you take a step back and ask yourself, what’s going to produce more effective knowledge translation, it’s not just going to be producing papers and talking amongst the already converted or amongst our colleagues. I’m not sure how you breed this amongst clinicians, but we need to be thinking more outside the box on a routine basis. And I don’t know if it’s just not well received. Actually, I know it’s not well received, that’s part of the problem. If you’re approaching a problem in a different way, it’s just not widely accepted. I’m gonna get a bit of slack for this, but I look at the world of critical care. When we look at our research, we have not moved the needle in years, in terms of our publication outputs. Yeah, you could add steroids and we improve mortality by like 2%, then the next study is showing it’s a negative outcome. All these approaches that are not moving the needle at all. And then you got to ask yourself, why are we approaching it the same way? Maybe we got to be more creative. Maybe we got to have a more personalized approach to our studies. Maybe we got to ask the question, steroids seems to help some people, let’s find out who that is. Maybe it’s the older people, maybe it’s people that have some liver impairment, maybe it’s somebody that has a specific type of infection, like pneumonia or urosepsis. Let’s try and think outside the box so that we can actually impact lives. And so, I’m totally going off on a tangent. But the point of what I’m getting at is, we need to encourage thinking outside the box. Part of that too, for me, was when it comes to communicating some of the large efforts within healthcare, it has to tailor to a more generalizable audience. It can’t just be to people that are getting into the weeds. Because I’ll tell you, one thing that I’ve learned too is the more people you invite in the discussion, the more perspectives, the more diversity in opinions and ideas, better solutions. I can’t tell you how many times, when you have those patient representatives on quality meetings, or what have you. And they’ll come and be like, yo, you ever think about doing this, you ever think about just putting that exit area just left to the desk? And then everyone be like, whoa man, that was fresh. And then the person just drops a microphone, just walks out of there like he’s balling. But it’s so important to have that wide perspective.

Chad Ball  24:17

It’s true. I’m sure you’re very familiar with Scott Page’s work, the Diversity Equation and what that means. It’s fascinating to listen to him talk about being called into everywhere from Mercedes Benz to much less famous commercial entities and talk about diversity and why it’s important. And all the points that you raised in terms of productivity, thinking inside or outside the box, depending which term you want, moving forward, efficiencies, relevance. And it’s just funny, he says he’s often met with mouth open, bewildering looks, by folks who just don’t seem to understand that.

Kwadwo Kyeremanteng  24:58

100%. Have you guys read the book by Adam Grant, Think Again?

Chad Ball  25:03


Kwadwo Kyeremanteng  25:04

Oh, my God. I just finished it. That’s why it’s fresh on mind. Tell me that wasn’t incredible. Like just that lens of how to expand your thinking, and just giving people that permission to question the status quo and how to approach these things. I don’t know. Sometimes you read a book. I listen to books mostly now, but you’re just like, I need to listen to that one again. I know I’m gonna go back to that one because there’s some gems in there.

Chad Ball  25:37

Yeah, totally. That message in that book is not per se, new. But the delivery of it is comprehensive, and it’s great. I often think when I listen to that topic and think about it. It’s interesting to me, who that, people around us where that is sort of innate. That’s an innate understanding, and they just kind of intuitively get it. Versus the majority of us, I think, that have to work on that intentionally going forward, to improve for sure.

Kwadwo Kyeremanteng  26:12

Yes. I just think, as you mentioned, the way he packaged that, the way he presented it, the examples he gives, was just so relatable. Just inspiring to get to just, I don’t know, it just makes you want to rethink. It makes you want to see how we can improve on so many of our processes and so forth. I don’t know, it was just so inviting. I just, I can’t speak about that book enough. And actually, he showed up on the latest episode of knowledge project with Shane Parrish. And it’s a nice little summary. I don’t know if you listen to that podcast, but it’ll change your mind grapes. It’s amazing.

Ameer Farooq  27:03

Okay. So, sure, yeah, it’s great. It’s nice to get the word out there. But I’m particularly impressed by how you navigate these topics. Because, and we’ll get into this a little bit, obviously COVID-19 totally took your podcast in a different direction and launched it. But when you’re trying to break down a complex topic, like any of the topics that you’ve had on the podcast, there is this dance that you have to do between getting into the weeds enough that people actually understand some of the nuances. I think one of the big problems with science journalism or medical journalism is that journalists tend to sensationalize things. Kind of weave a story when, perhaps, there isn’t one, or gloss over the details. But you’d seem to do a very good job of being able to stay nuanced, while at the same time making sure it’s general enough.

Kwadwo Kyeremanteng  27:50

No, I appreciate that, Ameer, question. Because it comes down to one of my main principles of when it comes to not only communication, but life. Is, like Pareto’s Principle. The 80/20 rule. But for those that don’t know, it’s kind of… if you’re a business owner, you look at your revenue stream. And what rule comes through, almost always, is that 80% of your revenue comes through 20% of your clients. So the whole argument is really focused on that 20%. And Perato’s Principle is everywhere, when it comes to your happiness, when it comes to traffic, when it comes to your workouts. What gives you the biggest bang for your buck. And so with every problem, I almost approach it that way. Even when I think of COVID response. I’m out in Ontario and one of the things that was screaming to me, which was really unfortunate, was that more than 80% of COVID cases were coming from a small area, within Toronto, the GTA. So, Peel, Scarborough, that area. And to me, it was like, we need to focus resources where the fire is. Look at that 80/20 in terms of what’s really driving cases in Ontario. And same thing when it comes to the show, trying to communicate. What is the message that you really want people to go home with? What is the thing that is going to make it, click? Or stick, I should say. So that’s why you could get caught up in the weeds in terms of a topic that doesn’t give you that much value. But ask yourself, what’s gonna make that message close to their heart? What’s going to make them leave the show and be like, man, I won’t forget that topic, I won’t forget that message? That’s kind of the general principle I use when it comes to the overall strategy or overall focus when we do our shows. But I mean, I’ll tell you when when Pareto’s Principle or the 80/20 rule, I apply it to everything. How I round, how I learn, when I teach. Let’s focus on the biggest bang for your buck. And it seems to work well.

Ameer Farooq  30:13

Part of it, I think, is the guests that you bring on. The guests that you’ve brought on have become, even if they weren’t stars before, they’ve gone on to become real stars. And I think in no small part due to being on the podcast. Certainly like Heidi Tworek, for example, I had not heard of her name prior to her being on your podcast. I listen to her religiously now. I follow her stuff on Twitter all the time, because her insights are just dynamite. Like all of them, like Suman Chakrabarti, a bunch of the guests that you have brought on the podcast have been just dynamite. They kind of understand how to do this dance too. How do you find such good guests? Because that’s a hard thing to do on a podcast, for sure.

Kwadwo Kyeremanteng  30:55

Oh man, Ameer, I was getting chills when you were talking about Heidi. Because I’m like, every time she talks, she drops a knowledge bomb that drops kick you in the chest. And then I’m like, what you say makes so much sense. So I heard her briefly on CBC Radio before. And I was just listening to her talk about communication. About, hey, simple message, look at Bonnie Henry, look how she’s communicating and being consistent and simple, and keeping it real. And I’m like, man, what you’re saying makes so much sense. And so this is why you try and find, when somebody that is so spectacular like that, that’s such a great communicator, you hear them speak, you got to reach out. So to me, it’s one of those things that, you hear them, you hear what the overall message is, you hear how they articulate. Like Monica Gandhi. Honestly, when I reached out to her the first time, she might have had 900 Twitter followers. Look at this. Look at her now, man.

Ameer Farooq  32:03

Yeah, she exploded.

Kwadwo Kyeremanteng  32:03

But like, once again, what a great communicator. Keeping it simple, focusing on the major topics, and simple message. I don’t know. To me, that’s kind of the theme, I guess. We’ve had some dry shows too. Where you like the topic matter, but then you’re like, yeah, man, this cat’s boring as hell. You try to pick them up and be talking about something that maybe makes them giggle or something. And they’re like, no, it ain’t biting. But this is the thing, I would say swing, man. Always consistently swing and just learn. What’s the expression? It’s fail fast. I’ve learned, for example, and I think you guys appreciate this with your show too. People, they don’t care who the guest is, you could have the biggest named guest in the world. I mean, there’s exceptions to that. You have Barack Obama on this bad boy, the whole country is listening to that. But it’s more about the flow. It’s more about the communication. It’s more about the connection. Like, right now, I’m telling you, people are loving this cast so far. Let’s get real.

Ameer Farooq  32:20

Yeah, we’re loving it for sure. Yeah. By the way, Barack, if you’re listening, open invitation to Cold Steel and Solving Healthcare, any time. We’ll make time for you maybe.

Kwadwo Kyeremanteng  33:38

Just not on weekends. Just kidding, anytime buddy, anytime.

Chad Ball  33:43

He’s just on the other line now, guys.

Ameer Farooq  33:48

So was it hard to get into COVID? How much did you think about that when pivoting talk about that. Because a lot of the episodes have become about COVID and I think, rightfully so, because there’s nothing else to really talk about over the last year and a half. But that must have been kind of nerve wracking to insert yourself into that discussion.

Kwadwo Kyeremanteng  34:07

So nerve racking, buddy. I gotta tell you, the motivation for it was a fewfold. One, I thought there was a lot of fear being thrown into the conversation. A lot of fear-based approaches, which is, I think, counterproductive when it comes to public health. On all the principles that we’ve always learned about. And so, that was one motivator. The second motivator was, which was the part I was most anxious about, in the first wave, we needed to do what we had to do in terms of do a severe lockdown. We didn’t know anything about this virus, we needed to gain information. But, like anything else, there’s got to be a level of balance. And when you start to see some of the negative parts of life by our restrictions. The delayed cancer diagnosis, to child abuse, domestic abuse, late presentations in terms of people coming into hospital, once again because of that fear messaging. I’m like, we got to increase the awareness of these problems, man. Like, we got to do something about it, you know? All of us in healthcare, some of us more than others, you have to have that kind of a holistic approach and say, if we’re gonna die Risa patient, how’s it gonna affect their kidney status? How’s it gonna affect their heart? So we weren’t having that discussion. And it wasn’t safe to have that discussion. I was seeing directly the consequences of us not having those discussions. You know, when I seen that MI that probably presented 2 days ago, or symptom onset was 2 days ago. And they’re coming in too late, and they’re dying from a heart attack because they were too afraid to come into hospital. That’s a problem. You know what I’m saying? And so, it’s part of also, probably growing up as, this might seem out of left field, but growing up racialized in a city like Edmonton, you stick up for people that can’t stick up for themselves. You do the right thing because you know how it feels. So for me, when we interviewed Michelle Ward and she’s telling me about the child abuse that was going on during the restrictions and during school closures. When you hear this, you can’t unhear it. You can’t. For me, it’s just not within my values to just be like, okay, I guess this is the way it is. Maybe we should just do nothing about it. Nah, man, it’s time to lead when you know people are in trouble. Especially kids, I mean, I thought I was gonna be a pediatrician. I just got a real soft spot for the kids. And so, my latest advocacy stuff has been around the school closure issues in Ontario. But honestly, it’s hard to just sit back when you know negative things are happening, especially to the kids. So I know that was a long winded answer to that question. But it just comes down to like pivoting towards that, because it was just a lot of injustice, in my mind, that was happening.

Ameer Farooq  37:33

It’s not easy to do what you did. I know you’re saying yes, it’s hard to sit back. But I’d argue that it is not easy to put your neck out there or stick your neck out there on a topic like this. You’ll get flack from other physicians. People will be like, well, how in the world can you say that we shouldn’t close schools? Do you not care about people, the lives of people? Do you want COVID to run rampant? That is not an easy topic. And you don’t want to be in that camp of anti-vaxxers. It’s almost become so politicized now, that you end up being in one of these camps, right? And so trying to strike a balance between those two camps is incredibly difficult. So yeah, I don’t know how you did that, honestly.

Kwadwo Kyeremanteng  38:16

Honestly, Ameer, there’s a couple of things that come to mind. I always, rightfully or wrongfully, I like to behave as if my kids were watching. They can see what was happening. And for me, with the platform, not to stick up and do the right thing, it never sat well with me. And the other thing that I think… I find I’m not perfect at this, but I try and be an example of not following the script, not avoiding something because I might fall into a category. Like, I want to show that, you know, our behavior is above that. I am not anti-vax because I’m talking about school closures. I’m not, you know, anti-white or whatever, because I’m worried that lockdowns are impacting other’s wellbeing. Like you could try and label me, but I’m above a label. I’m not a label, you know? I’m not in a specific box, I’m going to be nuanced because that’s what’s necessary to make these choices. And I feel like if enough of us act like a leader in that way, others will follow. Because come on, like to put people in such dichotomous boxes, when, like, how many things when it comes to health policy, could fall that clearly into one label. You know what I’m saying? So, I just, it’s hard. Like, if I told you some of the stuff I’ve gotten. Like I’ve had people come up to me and say I’m dangerous and you know, your positive messaging is dangerous. People are gonna die as a result of what you’re saying. I mean, luckily, it hasn’t been too much in my face. But then, I mean, Twitter world, holy cow. That’s malicious. Luckily, you know, I’ve been able to kind of, you know, I just silence. I just mute that stuff. I don’t engage at all. But it’s been relentless for the last year. But mostly positive, though. I don’t want to give a false picture of how this has gone. Like, the messages I get on almost a daily basis now has been so moving, you know? In terms of people appreciating the advocacy and the positive messaging and the balanced approach. It’s been fuel to keep going for sure.

Ameer Farooq  40:51

You’re obviously still a practicing critical care physician, right. So I think it kind of goes against the DNA of a lot of physicians to actually stick their neck out on any kind of topic. One, because I think on some level, we all get worried a little bit about being seen as bias or unprofessional, you know? Whatever that means. And then the second thing is, you know, you kind of worry about, how this will be perceived by other people in your department, you know? Your department head and how that all plays out. Like, how has that kind of played out, even like locally in the place that you work, even in terms of, I’m sure this has taken a lot of your time as well. How have you kind of managed that whole piece of your professional life with this, quote, unquote, side hustle? Although it’s kind of ridiculous to call this a side hustle.

Kwadwo Kyeremanteng  41:41

Honestly, it’s been, I mean, for most part, people have been really supportive. Like, I’ve only had one or two complaints, formal complaints. You know, whether it’s department hospitals, they’ve been quite supportive in knowing that, overall, you know, the message is quite similar. Listen to public health. We’re all ultimately after the same goal of getting through this pandemic. And so I think they see that. There’s a way of framing things, especially when you’re doing mainstream media saying: this is just my opinion. But I mean, they don’t have, like, I started as department head for my department as of July 1. So despite all this, the hospital still had faith in putting me in a leadership position. So, you know, I think people just see the intention, which is to get through this, the end. And, you know, the one thing I will say too Ameer, when it comes to COVID and COVID response. And I mentioned how this fear approach, in my opinion, is a negative one. This was a time for our leaders to be leaders, you know? Like, say if you were in a time of war. Imagine some of these, you know, Roosevelt or whomever was like, Man, you guys need to do better. We’re not gonna get through this. Like, we’re struggling. As opposed to, like, you know what, these are the steps we need to do collectively to get through this. And we’re gonna get through this. Please get vaccinated. Please listen to public health. You know, we could get through this together as long as we are unified in this goal. Like, why not have that twist? And so I think when you see someone like myself, going on the media, whether it’s through the podcast or mainstream saying, we could get through this, this is what we need to get through this. We’ll survive this, we’ll get through this on the other side, it just resonated with people. And it’s because that’s what leaders do. I don’t know when this fear tactic started to become a more mainstream approach to things. But, you know, I guess the short version of what I’m saying is that, or the long version, I guess, now is that people have been supportive, and I think it’s because the general message of trying to get through it and having a positive slant on things, it gets to people.

Ameer Farooq  44:24

It’s been very disappointing, in some ways. Like to have a worldwide crisis, and for all of us to go through it, and actually, in some ways, we’re more divided than ever, you know? Everything has become so much more politicized and certainly, you know, our leadership has in many scenarios kind of abdicated their ability to lead. It’s been really very disappointing from that perspective. You know, like, if the aliens were invading, we could have maybe mounted a response but somehow like, the fact… and maybe it’s just the nature of the disease. Like we all have to be at home and isolate. And so that’s why? But it’s been really disappointing.

Kwadwo Kyeremanteng  45:08

That’s an interesting point you make about the nature of the disease. I never really thought of it that way before. Because yeah, we can’t all be together. And usually, maybe if we were spending more time together, things would be, would present itself differently. But, yeah, it’s an interesting perspective. But I still think, you know, because we still got work to do. You know, we’re on the better side of it, in my opinion. But it’s still important hopefully for leaders to show true leadership qualities during this time.

Ameer Farooq  45:44

I do want to highlight another initiative of the, I don’t know how many, 10,000 things you’re doing. But another initiative that you’ve recently started, that’s just phenomenal, which is the solving wellness platform that you built. Can you talk a little bit to us about solving wellness, and what is going on with that?

Kwadwo Kyeremanteng  46:01

Yeah, thanks, Ameer for totally acknowledging that wellness initiative. Because I think it means a lot to us, especially because we saw how much burnout was happening pre-pandemic, and now during the pandemic or seeing people leaving the profession. Like we just felt compelled to do something about it. So we applied for a grant and was awarded through Montfort to help clinicians with burnout. So we have online live and and recorded fitness classes, yoga, nutrition advice, cooking classes, guided meditations. We have a cognitive behavioral therapist that helps with mindset and stress management. Like we wanted to do our part to try and mitigate the burnout risk amongst clinicians. Because for us to take care of our patients, we have to be on point man. Like we got to be ready to go. And the biggest worry I had is that as we’re gonna see more and more, you know, the baby boomers are coming of age where they’re going to be, you know, saturating the healthcare system, we need all hands-on deck. And so yeah, we produce this platform. And it’s been so amazing so far. We’ve got about 125 members so far. It’s been about a month, and the feedback has been great. The instructors have been great. We’ve had people donate memberships. And Ameer, if it’s okay with you guys, the “Cold Steel posse”, like I’m not sure when this comes out, but if they use a promo code code, “Cold Steel”, the first 10 people will get a free membership. For reals. Because I think we’re just trying to spread the word. Try and engage as many healthcare providers as possible. And if they use the promo code “ColdSteel15”, they’ll get 15% off signup fees. And because yeah, like what we say on the show, “we try to change that boogie, yo?” We’re trying to change the boogie within healthcare.

Ameer Farooq  48:09

That’s fantastic. So what is actually on the platform?

Kwadwo Kyeremanteng  48:13

Yeah, so literally, you’ll log in, and whether it’s a live or recorded version, you’re like, you know what, I’m in a community of likeminded, or not like minded, but like, people that have a shared experience of taking care of people in the healthcare system. And you have workouts that you have access to. Yoga classes, guided meditation. You wanted a cooking class, you know, that’s provided. You have recipes, you have a community too that you could chat with. Like, one of the things I dropped in, just yesterday was Adam Grant’s book. I was like, hey, guys, this is a great book on how to approach thinking, and just have that dialogue within our community. It’s been so rewarding, honestly. And, you know, I just think, once again, if we could amplify by making sure our clinicians are taking care of themselves, we will be that much better at the bedside. And the other thing, too, is some of the things that we learn within there. Like, oh, we do a lot of discussions on you know, different approaches to nutrition, like safer, intermittent fasting. A lot of healthcare providers are interested in that. Here’s the resources to say how you do it, what the benefits are. And if you feel like it’s a win, you could provide that for your patients too and just amplify the message that way. So it’s just been this incredible experience having that community feel to it. And, you know, Ameer I’m a dooer. This is an idea that came relatively quick, but we saw the need during the pandemic and we’re like, screw this. We’re gonna start this right now. And thanks to my team: Julia, Sarah, Sarah Dickinson, you guys have been great in getting this bad boy up and running.

Ameer Farooq  50:10

Yeah, it’s phenomenal. I mean, one of the interesting things is that, you know, I think one person could reasonably ask why specifically, develop a platform for wellness for clinicians or for healthcare workers. But, you know, like, our challenges are kind of unique. There is a big role for having someone who understands what those challenges are, from our perspective, because, you know, like, I’ll give you an example. We had Jane Lemaire, who is an internist in Calgary. And she’s been, you know, a huge person with regards to wellness and burnout in Calgary. And she did this study where they looked at what people ate during their day and their cognition and all that kind of stuff. And it was it was terrible what clinicians were eating? What are the specific challenges or things that healthcare providers face in terms of burnout that you feel that solving wellness can uniquely kind of challenge and target?

Kwadwo Kyeremanteng  51:09

I love this question, because it’s so many. So one of the topics, for example, I forgot to mention, is sleep. So we did a live webinar, where people ask questions that do shift work, for example. What you eat and same thing along those lines. What do you eat during shift work, especially if you’re going to try fasting. There’s a moral distress. Like we have, all of us, Chad, Ameer, we’ve all had those situations where we’ve had to take care of patients. And it’s been a challenge, you know, like it’s been a struggle to see them go through what they’ve gone through, especially during COVID. Like, for me, for example, one of the most distressing things in the first wave was seeing people die by themselves. People saying goodbye to their loved ones via FaceTime. Like, that was horrific. And so that’s a shared experience as a healthcare provider, you know what I’m saying? Of like, whether it is what you eat, whether it is how you sleep, whether it is that moral distress, or just any of those experiences? It’s that commonality. And so yeah, there’s some unique sides for us healthcare providers, especially. I think COVID really brought us together and put a lens on some of these issues. But definitely, yeah, we have that shared experience for reals.

Chad Ball  52:35

We try to end the podcast, as you know, with a pretty neat, sort of standing question. Which said, if you could go back, maybe just after the mean streets of Edmonton, but you know, when you were a resident or a critical care fellow trainee, and maybe even as an early attending, what kind of advice would you would you love to have been given by yourself, you know, back in those two time points?

Kwadwo Kyeremanteng  52:59

Honestly, there’s about 15 things I can think of that I would go back to tell my younger self, but I think the main thing I would say is: stay authentic. Stay your true self. And the reason I say that is because I think a lot of us lose ourselves during our training period. We try and please, you know, put on our hat where it’s gonna please the attending, please our colleagues. And we lose ourselves. And I think that adds to kind of the burnout and the stress of the job. But if you could come in wearing that hat of like, I’m just gonna be me. I’m gonna just be myself and naturally, I land in a place where I’m going to be appreciated and loved. I think that’s something I would have loved to implement in my career much earlier than I did. Because yeah. I mean, now, the way I’m speaking to you guys is the way I speak at rounds. You know what I mean? I’ll talk about practicing drop kicks, and sidekicks, or interpretive dancing. But, you know, back in the day, I don’t know if I would have had the courage to do that. But I think if I were to go back, it would be to stay true to yourself.

Ameer Farooq  54:24

You you’ve been listening to Cold Steel, the official podcast of the Canadian Journal of Surgery. If you’ve liked what you’ve been listening to, please leave us a review on iTunes. We’d love to hear your comments and feedback. So, feel free to email us at podcast.cjs@gmail.com, or connect with us on Twitter @CanJSurg. Thanks again.